NHIA Data Initiative

Definitions

Introduction
The NHIA Outcomes Task Force considered how other sectors of health care (e.g. acute care, long term care) are evaluating outcomes and quality, and arrived at the following set of elements as a starting point for our industry to define and adopt. The Final Standard Definitions for Patient Outcome Data Elements are as follows:

In addition to the above, the task force developed standardized Reasons, Interventions (for Adverse Drug Reactions and Catheter Events), and Outcomes for each element to assist providers in capturing additional l information related to each outcome. This additional information will go a step beyond the basic reporting and provide context for the reasons event occur, the clinical interventions performed, and the ultimate impact on the patient's use of home infusion services.

Additional Considerations as You Review

The definition for each element is intended to inform providers about whether or not an event should be counted for future industry-wide benchmarking purposes. The definitions do not attempt to define the population parameters or time frames for reporting. These elements will be incorporated in the "measure" for each data element once the definitions are finalized. A good example is the "unplanned hospitalization" definition. Providers are encouraged to document every unplanned hospitalization that occurs according to this definition. A possible measure may count hospitalizations for specific populations, or compare rates of unplanned hospitalizations between different types of therapies or patient groups.

The NHIA data elements are designed to consolidate data into broader categories to facilitate comparisons across different providers. For example: The reason "Change in Eligibility" encompasses many elements that impact whether or not a patient can receive home infusion services, such as caregiver status, reimbursement challenges, or loss of IV access. Providers may wish to collect more specific data at an organizational level; however the more detailed data would be mapped to the broader category for national reporting purposes.

NHIA recognizes that individual providers use a variety of software systems and processes to collect data, and understands that differences exist with regard to the clinical terminology used today. NHIA knows that some adaptation may need to occur to achieve standardization with these outcome data elements; however the Outcomes Task Force made every effort to develop data definitions that are broad enough to accommodate variations in software and data collection processes between providers.

Currently, no standardized reporting methods for the above Patient Outcome Data Elements are being proposed by NHIA. Individual providers should continue to evaluate and determine the best way to internally collect, analyze, summarize and utilize patient outcome data to improve quality and patient care practices. Efforts to create industry-wide quality measures to standardize the reporting of patient outcomes across multiple providers and provider types are underway.